Nimeri Abdelrahman, Al Hadad Mohammed, Khoursheed Mousa, Maasher Ahmed, Al Qahtani Aayed, Al Shaban Talat, Fawal Hayssam, Safadi Bassem, Alderazi Amer, Abdalla Emad, Bashir Ahmad
Bariatric and Metabolic Institute Abu Dhabi, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
Division of General, Thoracic and Vascular Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
Obes Surg. 2017 Jun;27(6):1543-1547. doi: 10.1007/s11695-016-2503-7.
Bariatric surgery is common in the Middle East region. However, regional accreditation bodies and guidelines are lacking. We present the current peri-operative practice of bariatric surgery in the Middle East region.
Public and private practice in the Middle East region.
A questionnaire was designed to study trends of peri-operative care in bariatric surgery. It was sent to members of the Pan Arab Society for Metabolic and Bariatric Surgery (PASMBS).
Ninety-three surgeons (88.6%) responded, 63.4% were in private practice, 68.5% have been in practice for more than 5 years, and 61.1% performed more than 125 cases per year. Laparoscopic sleeve gastrectomy (LSG) was the commonest procedure performed, then laparoscopic Roux-en-Y gastric bypass (LRYGB), one anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), and laparoscopic adjustable gastric banding (LAGB). Pre-operatively as a routine, 65% referred patients for dietitian and (78.3%) for smoking cessation. In contrast as a routine, 22.6% referred patients to a psychologist, 30% screened for obstructive sleep apnea (OSA), and when they did, they did not use a questionnaire. For patients 50 years of age, 22% performed a screening colonoscopy and 33.7% referred patients to a cardiologist. Intra-operatively as a routine, 25.3% placed a drain and 42.2% placed urinary catheters. In contrast, 77.1% performed a leak test (82.7% as a methylene blue leak test). Post-operatively, 79.5% used chemoprophylaxis for venous thromboembolism and 89% required patients to take vitamins. In contrast, 25% prescribed ursodeoxycholic acid.
The wide variation in the peri-operative care of bariatric surgery in the Middle East region highlights the need for regional guidelines based on international guidelines.
减重手术在中东地区很常见。然而，该地区缺乏认证机构和相关指南。我们介绍了中东地区减重手术目前的围手术期实践情况。
中东地区的公立和私立医疗机构。
设计了一份问卷来研究减重手术围手术期护理的趋势。问卷发送给了泛阿拉伯代谢与减重外科学会（PASMBS）的成员。
93名外科医生（88.6%）回复了问卷，63.4%为私立执业医生，68.5%的医生执业超过5年，61.1%的医生每年进行超过125例手术。腹腔镜袖状胃切除术（LSG）是最常实施的手术，其次是腹腔镜Roux-en-Y胃旁路术（LRYGB）、单吻合口胃旁路术/迷你胃旁路术（OAGB/MGB）以及腹腔镜可调节胃束带术（LAGB）。术前，65%的医生会常规将患者转介给营养师，78.3%的医生会让患者戒烟。相比之下，只有22.6%的医生会常规将患者转介给心理医生，30%的医生会筛查阻塞性睡眠呼吸暂停（OSA），但筛查时未使用问卷。对于50岁以上的患者，22%的医生会进行结肠镜筛查，33.7%的医生会将患者转介给心脏病专家。术中，25.3%的医生常规放置引流管，42.2%的医生常规放置导尿管。相比之下，77.1%的医生进行渗漏测试（82.7%采用亚甲蓝渗漏测试）。术后，79.5%的医生使用化学预防措施预防静脉血栓栓塞，89%的医生要求患者服用维生素。相比之下，25%的医生会开具熊去氧胆酸。
中东地区减重手术围手术期护理存在很大差异，这凸显了基于国际指南制定地区性指南的必要性。
